Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 10829412-3400 | UT |
NPI | 1114333598 |
---|---|
Provider Name | Roxanna Maurer |
First Address | Payson, UT 84651-2713 |
Second Address | Payson, UT 84651-2713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2014 |
Last Update Date | 13/07/2020 |